Salvaged Allogeneic Hematopoietic Stem Cell Transplantation For Patients With Recurrent Hematologic Malignancies After First Stem Cell Transplantation

Objective To observe the efficacy of salvaged allogeneic hematopoietic stem cell transplantation for 16 patients with recurrent hematologic malignancies after first stem cell transplantation.Methods A total of 16 patients with second transplantation were enrolled from October 2010 to January 2015. 8 patients were diagnosed as acute myeloid leukemia, 2 patients as acute lym poblastic leukemia, 6 as non-Hodgkin′s lymphoma. First transplant situation :13caces performed autologous peripheral blood stem cell transplantation,2caces performed unrelated mismatched transplantation and one case performed identical sibling transplantation.ALL patients were relapse after the first transplantation of 1 to 60 months. Salvaged allogeneic hematopoietic stem cell transplantation for all patients after first stem cell transplantation. The donors were identical siblings(4) or haploidentical family members(8) or underlated ones(4). Conditioning reg imens ma inly contained high-dose cytarabine plus BUCY/CY and TBI/CY. CSA,MMF,ATG and MTX were used to prevent graft-versus-host disease(GVHD). Results 16 patients aehieved complete engraftment.The median neutrophil recovery time was 12(9-16) d; the median platelet recovery time was 15(12-60) d. The incidence of grade II一1V GVHD was 40%, 3 patients with chronic GVHD. Follow-up observation: 9 cases survived, 5 cases died in hospital, 2 cases died during follow-up, Causes of death: 3 cases died of severe infections, sepsis and pulmonary infection; 3 patients died of acute GVHD: intestinal GVHD, liver and intestinal GVHD, one patient died of chronic GVHD. 29% patients achieved event-free survival(EFS), overall survival(OS) was 56%.Conclusions Salvage secondary allogeneic hematopoietic stem cell transplantation in patients with relapsed refractory hematologic malignancies, improve overall survival and event-free survival. Is one treatment option for patients with relapsed after the initial transplantation.